Behdad Shekoufeh, Ayatollahi Vida, Harrazi Hamid, Nazemian Naderali, Heiranizadeh Najmeh, Baghianimoghadam Behnam
Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. E-mail:
Shohaday-e-kargar Hospital.Yazd. Iran, E-mail:
Colomb Med (Cali). 2013 Jun 30;44(2):87-91. eCollection 2013 Apr.
Remifentanil, with its rapid activity onset and short duration of action, may be more effective than other opioids for providing hemodynamic stability during obstetric anesthesia. However, there is some evidence of adverse effects on neonatal respiratory function. We investigated maternal and fetal effects of Remifentanil during cesarean section surgery.
Eighteen women with singleton term pregnancies, and physical class status of I or II as defined by the American Society of Anesthesia (ASA), who were undergoing general anesthesia for semi-elective cesarean section were randomized into two groups (40 in each group) that received either an intravenous bolus of 0.5 µg/kg Remifentanil or the same dose of saline as a placebo. Maternal hemodynamic variables and neonatal umbilical artery pH and Apgar score at first and fifth min were evaluated in both groups.
Systolic and diastolic blood pressure were significantly lower after tracheal intubation and skin incision in the Remifentanil group as compared with the control group (p <0.05). There were no significant differences regarding heart rate between groups at any time (p > 0.05). Apgar scores at first and fifth min were not significantly different among groups (p>0.05). No neonate required assisted ventilation or naloxan administration.
Remifentanil may be a safe and effective drug for the induction of general anesthesia and surgical stimulation without subsequent neonatal depression.
瑞芬太尼起效迅速且作用时间短，在产科麻醉期间维持血流动力学稳定方面可能比其他阿片类药物更有效。然而，有证据表明其对新生儿呼吸功能有不良影响。我们研究了剖宫产手术期间瑞芬太尼对母体和胎儿的影响。
18例单胎足月妊娠、美国麻醉医师协会（ASA）身体状况分级为I或II级、接受半择期剖宫产全身麻醉的女性被随机分为两组（每组9例），分别静脉推注0.5μg/kg瑞芬太尼或相同剂量的生理盐水作为安慰剂。评估两组母体的血流动力学变量以及新生儿脐动脉pH值和第1分钟及第5分钟时的阿氏评分。
与对照组相比，瑞芬太尼组气管插管和皮肤切开后收缩压和舒张压显著降低（p<0.05）。两组之间在任何时间的心率均无显著差异（p>0.05）。两组之间第1分钟和第5分钟时的阿氏评分无显著差异（p>0.05）。没有新生儿需要辅助通气或使用纳洛酮。
瑞芬太尼可能是一种安全有效的药物，用于全身麻醉诱导和手术刺激，且不会导致随后的新生儿抑制。
